Concussion Clinical Trial
Official title:
Primary Prevention of Concussion in Youth Ice Hockey Players
1. Background and Rationale:
Little is currently known about intrinsic risk factors for sport-related concussion in
youth ice hockey players. Emerging research suggests that alterations in cervical and
balance function increase the risk of concussion in youth ice hockey players. Thus,
evaluation of a primary prevention program aimed at addressing alterations in cervical
and vestibular function may result in a protective effect in reducing the risk of
concussion. Such a program targeting intrinsic risk factors for concussion has not
previously been evaluated and thus a pilot Randomized control trial (RCT) to inform the
feasibility and efficacy of such a program is needed prior to proceeding to evaluation
of such a program on a larger scale.
2. Research Question and Objectives
The primary objectives of this pilot RCT study are: 1) To evaluate the feasibility of a
concussion prevention program in youth ice hockey players; and 2) To evaluate the
efficacy of a concussion prevention program in decreasing the risk of concussion.
Exploratory objectives include evaluating the changes in quality of life, clinical
measures of cervical and vestibular function measures and Hockey Canada on-ice skills
testing in youth ice hockey players following a concussion prevention program.
3. Methods
This study will be a pilot RCT. Prior to the 2017 hockey season, 120 players from 8 youth ice
hockey teams ages 13-17 will be recruited to participate. Once parental consent and/or player
assent has been obtained, players will complete a series of initial intake forms. Baseline
tests and measures, including a standardized preseason baseline questionnaire (regarding
playing history, past medical history, participation in sport) and a battery of
questionnaires and clinical measures. Individuals will be randomly allocated into either a
control protocol (general cardiovascular warm-up, general stretching and strengthening,
education on concussion identification) or a specific protocol (balance, neuromotor control,
strength, vestibulo-ocular and oculomotor training + concussion education). Both groups will
meet with the study physiotherapist once weekly for 4 weeks and exercises will be progressed.
A previously validated prospective injury surveillance system will be implemented. As part of
this process, a team designate will collect data throughout the season regarding individual
player participation in games, practices and dry land training sessions. Individuals with a
suspected concussion will be referred to the study sport medicine physician for evaluation,
diagnosis and standard of care management. At this time all baseline tests and measures will
be repeated.
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